Saskatoon FP nominated to be next CMA president

Dr Anne Doig talks to NRM about her election win, her plans and her six kids

Congratulations on winning the Saskatchewan nomination. How do you feel? Relieved. No, obviously, I'm pleased this is the outcome and look forward to the challenges over the next three years.

You were the only woman in the race. Did you see yourself as the Hillary Clinton of the CMA race? No. And I don't think my husband would like to be compared to Bill, either.

Was it uncomfortable running against several of your colleagues on the Saskatchewan Medical Association board of directors? I know every single one of the six people who were running with me, and some of us are currently on the board at the same time, but there was no real sense of any kind of adversarial tension at all. We're a bunch of people that get along very well together and we respect one another's strengths. We knew whichever one of us got elected would be a good person. It's all good.

Are you worried that somebody might decide to challenge you for the CMA presidency at the annual meeting in Montreal in August? It happened to current president Brian Day in Charlottetown in 2006. Well, there was a specific reason that happened. The bylaws of the CMA permit nominations from the floor to come forward. Anything could happen. I have no real reason to expect it, but, you know, it's possible. Typically in those challenges at the CMA, it takes a fair bit for the named person to be overthrown. There would have to be a substantive issue or, God forbid, something that would come up and besmirch my reputation between now and then. But if you're asking if I'm reasonably confident I'll be elected in August, yes I am.

What do you hope to achieve as CMA president? I'm a family physician, I deal with patients all day every day and I'm seeing the effects of systemic problems. It's not just surgical wait times, it's not just single issues -- I think really Canadians are just beginning to become aware of a much larger systemic problem with healthcare that's out there. Really my goal would be to work with my colleagues as physicians -- we have always believed it is our responsibility -- to speak for patients, and not to represent self-interest.

Speaking of self-interest, CMA delegates in the last two elections chose private clinic owners as presidents: Brian Day and Robert Ouellet. Where do you stand on the role of the private sector in healthcare delivery? There's no single right answer to that question. We'd be stupid if we didn't look at alternative solutions. In the same way that everyone is arguing physicians should accept alternative payment, we need to look at alternative payment for whatever we're talking about in terms of healthcare delivery. That doesn't mean we go out to the insurance sector and say, okay, we're going to carve off this piece and give it to you. What it means is we have to look creatively at how we pay for things, what we are paying for, why we're paying for it, who's accessing, who's being denied access, and really take a critical look at the system's issues behind that. Anywhere you look in the world where there's a single payer you've got problems with purchasing power and problems with access.

Are the provinces and the feds doing enough to fix the systemic problems you're worried about, like wait times guarantees? It's positive that ministries of health are looking at this and saying we are asking for performance guarantees and we are willing to put some dollars behind them, but the problem is they may not have the right things to measure. That's not to say surgical wait times are not an issue, because they are, but they're the really sort of catchy issue.

I'll give you an example. A patient of mine, in his early 40s, has very severe coronary artery disease. While he was waiting over six months for an initial consultation with a cardiologist, he came into the office with a worsening of his angina. That's disgraceful. But he wasn't urgent enough to justify me picking up the phone to call the heart guy to say you've got to see this guy early. That's the hidden wait. That's an access issue the patient is aware of, that I'm aware of, but to the folks running the wait times guarantees, that's an invisible access issue.

Tell me about your father's involvement in the so-called Medicare Crisis in 1962, when doctors went on strike to oppose the province's new medicare system. Well, my dad -- among hundreds of other physicians -- was a member of what was then the College of Physicians and Surgeons in Saskatchewan in the lead-up to the crisis. And, partly because he was a physician who had fairly recently immigrated to Canada from Britain [where the National Health Service was established in 1948], he had some strong opinions about some of the risks of going into a fully publicly-funded system and he was certainly vocal in the debates. Having said that, the debate was not about who should pay physicians. It's critically important that the primacy of the relationship between the patient and the physician is maintained and that the payer, whether it's an insurance company or the government or some external agency, shouldn't come between that.

I read that you owned and operated a grain farm. That farm had been in my husband's family for 102 years. We sold it this year to, in fact, another family who homesteaded in the area at the same time, so we feel as though we didn't quite desert the farm.

And you've still managed to find time for swimming. Yes. That's the one sport I glom onto.

What other things do you do for fun? A lot of things. I sing in a choir. My kids have been involved in various branches of music, mostly piano. My husband plays trumpet in a concert band. My second youngest son achieved a Nationals qualifying time in swimming in the last swim meet he was at, so he'll be going to Nationals, which is Olympic trials. He's at the bottom of the pile, but that means I'll be going to Montreal for Olympic trials as an official.

Very cool. Oh, yeah.

Are swimming parents like all those rabid hockey parents? Swimming's a little different than that. Most of us who are involved as parents in that sport have to get out on the deck and actually work as officials. We don't get to get to sit on the sidelines and scream at our kids.

In five words or less, how have you managed to maintain your family practice, run a grain farm, swim competitively, get involved in medical politics and have six children? It just happened.

Just kidding, you can use more than five words. You make time for what interests you. I've been very fortunate in that my husband is not a physician, he's a mechanical engineer, so he was often able to pick up the slack in terms of child care. And we had a babysitter who was with us for 16 years and was extraordinarily reliable. Things in that respect have worked out very well for us. We were very fortunate our children are healthy and we haven't had to take a hard look at our parenting responsibilities and say, "Whoops, I need to focus on something other than my profession."

Physician health has become a huge issue. Is that something you're hoping to work on? You'd have to ask my kids whether they feel I in any way neglected them.

I was thinking more in terms of policy. Yeah. We do have to look at the whole issue of work-life balance as it relates to medical practice. That is part of why there is going to be a huge health human resources crisis in the next five to 10 years. Part of it is the impact of what happened as a result of Barer-Stoddart, the reductions in admissions to healthcare over the previous 15 years. We're starting to see a reversal of that -- medical schools have increased their enrolments, so have some of the other healthcare disciplines. I had no choice. There was no such thing as a maternity benefit for me. With one of the kids, it was only six weeks after delivery when I went back to work. I did what I had to do, but I don't think my kids suffered as a result of and I don't think I suffered either.

But I do think younger physicians looking at me and saying, "Good god, girl, you're crazy. What you did is just not what I want to do." And that creates some tensions of its own. Obviously we're going to have to make sure those kinds of issues are addressed for our younger colleagues. As professionals we do have to put our professional responsibilities first and that doesn't mean sacrificing detrimentally your personal life, but it does mean more of a sacrifice than someone who is in a more traditional employment model.

Interview conducted by Sam Solomon